In 2008, fewer than 300 people attended my annual 10 town hall meetings. This year, 4,980 people attended. I heard a diversity of opinions and ideas on many issues. All citizens were given the opportunity to express their concerns. No one was shouted down; all were treated with respect.

There was consensus on a few of the major issues. The stimulus has been an expensive failure. It was a missed opportunity to create much-needed jobs. The bailouts were an enormous injustice to taxpayers by forcing them to reward the self-inflicted failures of Wall Street. If cap-and-trade passes the Senate, the middle class will pay a huge price in lost jobs and higher energy costs. Faithfully representing the interests of my constituents, I voted against each of these bills.

By far, the hottest topic was health care. At each meeting, when I asked how many people believed our health care system needs meaningful reform, almost every hand went up. However, the overwhelming majority of my constituents expressed deep concerns about the 1,018-page health care bill. I share their concerns about a government takeover of health care.

President Barack Obama has repeatedly stated, If you like your [health insurance] plan, you can keep it. However, independent analysts have determined that this statement is inaccurate. The Washington Post said, Obamas promise is not just at odds with legislative proposals  it is also at odds with reality. And the American people are not buying it either.

The legislation actually encourages small businesses to drop health insurance for their employees by making it cheaper to simply pay a fine. One research group, referred to as the gold standard of independent health care analysis by a Democratic Senator, projects that two out of every three workers will be forced out of private insurance and into the government-run health care exchange.

The exchange is an artificial market for health insurance where qualified private plans would compete against the public insurance option. Many fear that the exchange will ultimately kill off private health insurance. Thats because in the exchange the government will decide what benefits private insurance can offer and what they can charge for them. While these rules are bankrupting private insurance, the government can stay in business by using tax dollars to cover its losses. The logical result will be higher taxes for all Americans.

The need to curb the rising cost of health care was a frequently voiced concern at the town halls. However, the Congressional Budget Office projects that this $1.3 trillion plan will add $236 billion to the deficit in the short run and generate substantial increases in federal deficits in the long run. The CBO also projects that the government takeover will do very little to lower costs for patients.

I heard many concerns about the possibility of rationed health care services. By dictating what benefits private insurance can provide in the exchange, the government is granting itself supreme authority over health care services.

As the cost of the public option spirals out of the control, the necessary savings will likely come from limitations on services. As the presidents chief health care adviser explains, Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality of care are merely lipstick cost control, more for show and public relations than for true change.

The way rationing works is that government bureaucrats conduct what is known as comparative effectiveness research. CER, which received more than $1 billion in stimulus funds, determines what health care services are cost-effective given a patients age and projected quality of life. Care is approved or denied accordingly.

We can see this phenomenon in Medicare where because of its unsustainable costs, benefits are limited. As a result, most seniors require supplemental insurance. Medicare is a vital program that must be protected, but it is also a cautionary tale. Medicare currently has $74 trillion in looming obligations that no one knows how to pay for, and furthermore, the care it provides is insufficient.

Speaking of Medicare, the current legislation calls for $362 billion in cuts to Medicare. I heard from countless seniors who are worried about what these cuts will mean for them. The New York Times wrote that opponents can make a plausible case that the cutbacks could inadvertently reduce beneficiaries access to some types of care. To deny the relationship between health care costs and health care services is illogical.

At town hall meetings, I presented several ideas that I believe represent a better approach to health care reform. Association health plans would allow small businesses to pool their resources and purchase affordable health insurance for their employees.

I want to create a truly competitive market for private insurance by allowing individuals and businesses to purchase insurance across state lines. If we could foster greater competition between insurance companies, costs would decline while choice and quality would increase.

Insurance companies should not be able to discriminate against patients with pre-existing conditions. It is important to point out that each of these proposals is vehemently opposed by the insurance industry.

Lawsuit abuse significantly raises the cost of health care and denies justice to the real victims of medical malpractice. Doctors often order expensive but unnecessary tests and procedures, a practice known as defensive medicine, to defend themselves against potential lawsuits. Lawsuit abuse reform would deliver justice to the truly injured by clearing out the frivolous lawsuits that clog our legal system.

Once these proposals are implemented and the cost of insurance is dramatically reduced, the uninsured could afford coverage with the help of refundable tax credits.

Americans want health care reform that protects what is truly great about our current system. Our cancer survival rates are unmatched the world over. America is home to the extraordinary innovations in medical technology that save lives every day. We should all be concerned that government-run health care would stop rewarding such innovation and therefore diminish this powerful incentive.

Proponents of a government takeover are declaring our health care system a failure based on two key points. First, the U.S. lags slightly behind a handful of other developed countries in life expectancy. What they realize, but fail to point out, is that this is largely attributed to our poor eating habits and the alarming rate at which we kill ourselves and each other.

As columnist Steve Chapman recently wrote, our health-care system is doing a poor job of preventing shootouts and drunk driving but a good job of healing the sick.

The other failure of our health care system is its cost. On this point, we all agree. But theres one obvious problem. The Democrats proposal increases costs. So why are we still debating a bill that utterly fails to meet such a primary objective of reform?

Health care reform is necessary, but it will not work without the support of the American people. My constituents, and so many others who attended town halls in August, have sent a clear message to Washington. For those willing to listen, Americans are withholding their support until Obama agrees to get Congressional Republicans and Democrats in a room to hammer out meaningful, bipartisan reforms. The ball is in the presidents court.

Rep. Patrick McHenry (R-N.C.) serves on the Budget, Financial Services, and Oversight and Government Reform committees.